This report is produced from the proceedings of the Inception workshop on “Strengthening National Capacities and Policies for Food Systems analysis and Transformation in Ghana” project held on Wednesday, 2nd August 2023 at Alisa Hotel, Accra. The workshop aimed to provide a comprehensive overview of the project and outlined its objectives, and timeline, alongside a review of the current landscape of the Ghana’s Food Systems Transformation. It brought together various stakeholders and institutions in the Ghanaian food systems. The workshop facilitated valuable discussions among participants to gather insights and inputs for the project's advancement (see attached list of participants). Three distinct presentations – project overview, project deliverables and timelines, and food systems diagnostics and tools as well as trade-offs and opportunities – were made at the workshop.

This publication presents an in-depth analysis of the food system in Ghana with the dual purpose of providing an overview of the current situation, and identifying opportunities for leveraging the role of small and medium-sized enterprises for nutrition-sensitive food systems. The data collected and the results of the analysis enhance the understanding of some of the challenges that, in the Ghanaian context, contribute to determining diet-related issues; more importantly, the analysis identifies opportunities and entry points for improving diets by overcoming some of the challenges faced by small and medium-sized enterprises. The information provided could be of support not only for further analyses, but also for planning interventions and designing policies to improve nutrition in Ghana and in other contexts.

In recent decades, Ghana has experienced high economic growth and transformation, which contributed to the nation achieving the Millennium Development Goal targets on reducing extreme poverty and hunger. Against this background and in view of achieving the food and nutrition security targets of the Sustainable Development Goals, Ghana started a process of reviewing its food security and nutrition strategies and policies, including the overarching Zero Hunger Strategy. This discussion paper aims to contribute to this process by providing an update on the state of Ghana’s food and nutrition security. In addition to providing an overview of long-term historical trends at the national level, this analysis provides an overview of regional patterns of food and nutrition insecurity and recent changes across Ghana’s 10 administrative regions. Finally, the analysis identifies regional “hot spots” of food and nutrition insecurity. This paper confirms that Ghana has achieved substantial improvements in food and nutrition security overall, especially over the past decade. Nationwide, progress has been made in improving households’ economic access to food by reducing poverty and extreme poverty and in reducing chronic and acute child undernutrition. However, progress in reducing micronutrient malnutrition—particularly anemia and especially among young children—has been more modest. Across Ghana, large rural-urban gaps and regional differences—mainly between the north and the south—remain for most dimensions of food and nutrition security. In addition, Ghana is increasingly facing new nutrition-related public health problems that result from overnutrition and diets too rich in calories. Overweight and obesity among adults are rising rapidly in both urban and rural areas, leading to an increase in the risk of noncommunicable diseases. The rising double burden of malnutrition—that is, the coexistence of overnutrition and undernutrition, including micronutrient deficiencies—constitutes a challenge to public health and social protection policy. These new nutritional realities may make some existing food and nutrition security policies obsolete or even detrimental to nutrition security.

Global estimates show over half a billion people go hungry (FAO, 2020) and close to 2 billion people are either obese or overweight with another 2 billion of the world’s population suffering from micronutrient deficiencies (Micha et al., 2020, Fresco et al., 2017). Inarguably, the world faces significant malnutrition problem (including micro- and macro-nutrient deficiencies, obesity, and diet related non-communicable diseases). This is evident in a recent analysis pointing out that effort in achieving the Global Nutrition Targets is likely to be missed. The observed malnutrition threat is accompanied by climate change, which is influencing food production and consumption trends, and thereby leading to undernutrition and affecting overall development. In addition, there are growing incomes, accelerated urbanization, and expanding middle classes which are also causing significant changes in consumer behaviour and nutritional choices, necessitating both public and private expenditures for better food market integration. As a result, there is a pressing need to examine our food systems to guarantee food and nutrition security and to advance sustainable development. It is likely that the COVID-19 impact may further exacerbates the worsening food insecurity and nutritional status of the most vulnerable groups including women, children and adolescents, refugees and displaced people, smallholders in rural areas, and the urban poor.

Like other countries in the sub-region particularly West African economies, Ghana is grappling with multiple burdens of malnutrition which is accompanied by climate change that influence food production and consumption trends, and thereby leading to undernutrition and affecting overall development. In addition, growing incomes, accelerated urbanization, and expanding middle classes are also causing significant changes in consumer behavior and nutritional choices, necessitating both public and private expenditures for better food market integration. While food insecurity, and undernutrition (e.g. stunting, micronutrient deficiencies) persist, obesity and diet-related non-communicable diseases are rising rapidly. General nutrition situation and identification of the highest priority nutrition problems. Various estimates of nutritional status of Ghanaian children under aged 5 years show that 19% were stunted, 5% were wasted, and 11% were underweight. In 2018, the Multiple Indicator Cluster Survey (MICS) showed nearly similar rates of stunting (18%), wasting (7%) and underweight (13%), suggesting that stunting prevalence improved only marginally during the last 5-6 years, whereas child wasting and underweight worsened during the period. Other significant problems of undernutrition in Ghana include a high prevalence anemia in children 6-59 months (55%), adolescent girls (48%) and women of reproductive age (42%). From the foregoing, the high priority nutrition challenges in Ghana, include “stunting and wasting in children under 5 years of age; anemia in children 6-59 months of age, adolescent girls, and women of reproductive age; but also, overweight and obesity in school-age children and younger adolescents; and overweight and obesity in women of reproductive age (15-49 y of age). Report of the Demographic and Health Surveys show a significant rising trend in adult obesity – from 10% in 1993 to 40% in 2015 (GSS et al., 2015). Also, the Ghanaian food environments (particularly in the urban areas) is currently characterized by cheap highly-processed foods, with nutrient-dense foods such fruits and vegetables lacking in meals because it is unaffordable (Laar, 2021).